{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:04:27Z","timestamp":1775556267805,"version":"3.50.1"},"reference-count":34,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Physiotherapy Canada"],"published-print":{"date-parts":[[2024,5,8]]},"abstract":"<jats:sec><jats:title>Purpose:<\/jats:title><jats:p> This study determines barriers and facilitators to including people with lower limb amputation (LLA) in cardiovascular rehabilitation programmes (CRPs). <\/jats:p><\/jats:sec><jats:sec><jats:title>Method:<\/jats:title><jats:p> Canadian CRP managers and exercise therapists were invited to complete a questionnaire. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> There were 87 respondents. Of the 32 CRP managers, 65.6% reported that people with LLA were eligible for referral, but of these, 61.9% only accepted people with LLA and cardiac disease, and 38.1% only accepted them with \u2265 1 cardiovascular risk factor. CRP eligibility progressively decreased as mobility severity increased, with 94% of programmes accepting those with mild mobility deficits but only 48% accepting those with severe deficits. Among therapists in CRPs that accepted LLAs, 54.3% reported not having an LLA participant within the past three years. Among all responding therapists and managers who were also therapists ( n = 58), 43% lacked confidence in managing safety concerns, and 45%, 16%, and 7% lacked confidence in prescribing aerobic exercise to LLA with severe, moderate, and no mobility deficits respectively. There was a similar finding with prescribing resistance training. LLA-specific education had not been provided to any respondent within the past three years. The top barriers were lack of referrals (52.6%; 30) and lack of knowledge of the contraindications to exercise specific for LLA (43.1%; 31). Facilitators included the provision of a resistance-training tool kit (63.4%; 45), education on exercise safety (63.4%; 45), and indications for physician intervention\/inspection (63.6%; 42). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> Most of the CRPs surveyed only accept people with LLA if they have co-existing cardiac disease or cardiovascular risk factors. Few people with LLA participate. Education on CRP delivery for LLAs is needed to improve therapists\u2019 confidence and exercise safety. <\/jats:p><\/jats:sec>","DOI":"10.3138\/ptc-2022-0043","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T20:44:35Z","timestamp":1671050675000},"page":"199-208","source":"Crossref","is-referenced-by-count":1,"title":["Barriers and Facilitators to Cardiovascular Rehabilitation Programmes for People with Lower Limb Amputation: A Survey of Clinical Practice in Canada"],"prefix":"10.3138","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3186-400X","authenticated-orcid":true,"given":"Susan","family":"Marzolini","sequence":"first","affiliation":[{"name":"From the:  KITE Research Institute, Toronto Rehabilitation Institute \u2013 University Health Network, Toronto, Ontario, Canada"},{"name":"Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Physical Therapy, University of Toronto, 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